Does surgical site infection diagnosed after hospital discharge worsen clinical outcomes and increase resource utilization compared to controls?
Surgical site infections diagnosed after hospital discharge are associated with significantly increased healthcare costs, resource utilization, and decreased mental health scores.
Although surgical site infections (SSIs) are known to cause substantial illness and costs during the index hospitalization, little information exists about the impact of infections diagnosed after discharge, which constitute the majority of SSIs. In this study, using patient questionnaire and administrative databases, we assessed the clinical outcomes and resource utilization in the 8-week postoperative period associated with SSIs recognized after discharge. SSI recognized after discharge was confirmed in 89 (1.9%) of 4,571 procedures from May 1997 to October 1998. Patients with SSI, but not controls, had a significant decline in SF-12 (Medical Outcomes Study 12-Item Short-Form Health Survey) mental health component scores after surgery (p=0.004). Patients required significantly more outpatient visits, emergency room visits, radiology services, readmissions, and home health aide services than did controls. Average total costs during the 8 weeks after discharge were US dollars 5,155 for patients with SSI and US dollars 1,773 for controls (p<0.001).
Perencevich et al. (Sat,) studied this question.